Provider Demographics
NPI:1558045948
Name:MADAR, ERIN ELISE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:ELISE
Last Name:MADAR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9365 OLDE 8 RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-2052
Mailing Address - Country:US
Mailing Address - Phone:330-467-6066
Mailing Address - Fax:
Practice Address - Street 1:9365 OLDE 8 RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-2052
Practice Address - Country:US
Practice Address - Phone:330-467-6066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.027270122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist